Concussion

1. What are the grades of concussion?
2. What are the Colorado Medical Society guidelines (endorsed by AAN) for return to play after a Grade 1 concussion?
3. Grade 2 concussion?
4. Grade 3 concussion?


Answers:
1. Grading system used is either the Cantu or Colorado systems. Colorado system: Grade I (mild) involves no LOC and confusion without amnesia. Grade II (moderate) involves no LOC and confusion with amnesia. Grade III (severe) involves LOC.
2. For a Grade 1 concussion, return to play after asymptomatic for 15 min or less. For multiple Grade 1 concussions, return to play after asymptomatic for 1 week.
3. For a Grade 2 concussion, return to play after asymptomatic for 1 week. For multiple Grade 2 concussions, return to play after asymptomatic for 2 weeks.
4. For a Grade 3 concussion, return to play after asymptomatic for 1 week if the LOC is only seconds. If the LOC is in minutes, return to play in 2 weeks. For multiple Grade 3 concussions, return to play 1 month or longer, based on decision of physician.